Table 3 Summary of included studies in this review of Chew and Spit behaviour

Song, Lee, Jung [28]

To investigate the relationship between CHSP and other ED related symptoms

359 Patients (Mean age = 23.2, SD = 6.6) diagnosed with EDs using DSM-IV-TR by a psychiatrist

Cross-Sectional Study. Results of ED patients who CHSP were compared to those who do not CHSP. ED symptoms compared included: EDs, Food Craving, Body Shape Dissatisfaction, Depression, Anxiety, and Obsessive Compulsive tendencies

Questionnaires including EDI-2, FCQ, BSQ, BDI, BAI, and MOCI

Mind & Mind ED Clinic presentations between 2010 and 2012 in Korea

Not Specified

Guarda, Coughlin, Cummings, Marinilli, Haug, Boucher and Heinberg [32]

To evaluate the prevalence and frequency of CHSP in trans-diagnostic ED patients

301 Patients (Mean age = 25, SD = 10) were diagnosed by trained interviewers using the structured clinical interview for DSM-IV

Cross-Sectional Study. Results of ED patients who CHSP were compared to those who do not CHSP. Questionnaires addressed demographics, ED symptoms and frequencies

Researcher developed questionnaire, EDI-2 and BDI.

Patients with consecutive admissions to a behavioural, inpatient, and partial hospitalization program for EDs

IP and POP

De Zwaan [37]

To present a novel case report on one patient

19-year-old female with a history of EDs (AN, 43 kg/15.6 kg/m2).

Case Study, 1 Patient

A case report

Psychotherapy treatment setting

OP

McCutcheon & Nolan [39]

To present a novel case report on two patients

Patient 1: 27 year old female

Patient 2: 19 year old female college student

Case Report, 2 Patients

A case report of two subjects

Psychotherapy treatment setting

Not Specified

Makhzoumi, Guarda, Schreyer, Reinblatt, Redgrave, and Coughlin [36]

To characterize CHSP in a large sample of ED inpatients treated in a hospital-based behavioural speciality program. To investigate associations between regular CHSP and personality dimensions, ED and depression symptomology, and short-term clinical outcome variables. To examine CHSP including the amount of food typically consumed and frequency of Loss of Control (LOC) associated with CHSP behaviour.

324 Patients (Mean age = 29, SD = 12.4) were diagnosed by trained interviewers using the structured clinical interview for DSM-IV

Cross-Sectional Study. Results of ED patients who CHSP were compared to those who do not CHSP. Questionnaires addressed demographics, ED symptoms and frequencies

Frequency and overall number of nine types of current and lifetime ED behaviours were assessed using a researcher developed questionnaire, BDI, EDI-2, NEO-FFI.

Patients with consecutive admissions to an integrated inpatient partial hospital treatment program for EDs who agreed to participate in an outcome study

IP and POP

Kovacs, Mahon, and Palmer [38]

To study the prevalence and association of CHSP in a series of patients with AN, BN, and EDNOS

710 adult patients (Mean age not specified) were diagnosed according to the criteria outlined in the DSM-III-R

Cross-Sectional Study. ED patients who CHSP were compared between ED subtypes (AN, BN, and EDNOS) and those who did not engage in CHSP

Clinical Eating Disorder Rating Instrument (CEDRI), defined binging (DSM-III-R definition), subjective overeating, and subjective distortion of body image.

Inpatient ED Service of the Leicester General Hospital between 1991 and 1998

IP

Durkin, Swanson, Crow, Mitchell, Peterson, and Crosby [35]

To promote cohesion between existing CHSP literature (CHSP is trans-diagnostic) from an out-patient perspective

972 outpatients (Mean age = 24.6, IQR = 20.66–31.10)

Cross-Sectional Study. Patients were classified as having current CHSP behaviour or having had CHSP (at any frequency) during their lifetime.

EDQ. CHSP behaviour was assessed was determined by using 2 general EDQ items.

Patients evaluated at the Outpatient ED Clinic at the University of Minnesota between 1985 and 1996

OP

Mitchell, Pyle, Hatsukami, and Eckert [1]

A presentation of information about CHSP in BN patient engaging in the behaviour at high frequency, including information about their associated ED symptoms, treatment histories, and related psychopathology

Patients (Mean age = 23.9 y, SD = 5.3) who presented at an ED clinic prior to the commencement of the study.

Retrospective analysis. 25 patient files were retrospectively examined for indications of CHSP

Files of patients were retrospectively evaluated and diagnosed based on the information present in the files that corresponds to the DSM-III BN criteria and who engaged in CHSP

Files of patients evaluated at the ED Clinic at the University of Minnesota over three years prior to this 1987 study.

Not Specified

Smith and Ross [33]

To present a novel case report on one patient

28-year-old Caucasian obese female with no previous history of ED behaviour, but with a history of treatment for bipolar disorder.

Case Study, one Patient

A case report

Psychotherapy treatment setting/physician directed PSMF

OP